Well looked after, they have few health problems, the most common being eye ulceration, for as they have very large forward facing eyes, and being very inquisitive, they tend to poke their heads through grass and bushes, amongst other things. This can be mitigated, however, by daily examination and cleaning.
Hernias occur quite frequently, but are generally small and unless they increase in size are not a problem.
Heart murmurs are not uncommon, but the majority do not cause any trouble and need no veterinary action.
The key to Shih Tzu’s health is good and careful “dog watching”.
Please do get your dog insured. Vet bills are very expensive and seem to rise year on year.